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What Are the Medicare Secondary Payer Reporting Requirements for Our Company’s Group Health Plans?


Are employer-provided health plans are subject to Medicare Secondary Payer (MSP) mandatory reporting requirements?

Certain insurers, TPAs, plan administrators, and fiduciaries must report information to CMS about individuals who are entitled to Medicare and covered under a group health plan. The purpose of the MSP mandatory reporting requirements (sometimes referred to as Section 111 reporting) is to help CMS determine whether a plan is primary to Medicare (that is, whether a plan pays first, and Medicare is a secondary payer).

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